[A case of Hurst's encephalitis complicated by hepatoma]

The patient, a 29-year-old female, was hospitalized because of clouding of consciousness, fever and right hemiplegia 4 days after the onset. On first examination she was found having fever in the 37 degree range, positive CRP, hepatomegaly, anemia and hepatic function impairment. Neurological examination revealed somnolence, conjugate deviation to the left and stiff neck. The muscular power measured about 3+ for the upper extremities and 0 for the lower extremities. Babinski sign was present on the right side. The spinal fluid showed an increase in cell counts, especially the neutrophil count. CT scans showed diffuse white-matter hypodensity in the left hemisphere. Soon after admission the patient fell into coma and died 6 days after admission. Autopsies led to a diagnosis of Hurst's encephalitis complicated by hepatoma with liver cirrhosis. It was reported that the immune complex was found in 25.9% of liver cirrhosis patients. From this fact it is suggested that Hurst's encephalitis might be elicited by some immunological mechanism.